Billing code 28285: Hammertoe repairMedicare rate & RVUs

Medicare pays $548.44 for 28285 nationally in the office and $370.75 in a hospital or facility. Local office rates run $489.80–$711.32.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 28285 covers

This procedure corrects a hammertoe, typically a lesser toe with a flexed, contracted joint that cannot be adequately addressed by conservative care. A foot and ankle surgeon or podiatrist may correct the deformity by treating the interphalangeal joint, for example with fusion or partial bone resection. The operation is commonly performed in an outpatient surgical setting. The specific technique depends on the deformity and operative findings.

Report the service for each toe surgically corrected, identifying the toe and side in the claim and operative documentation. The record should describe the deformity, the toe treated, and the corrective work performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 applies to bilateral performance, paid at 150%. Medicare does not pay an assistant at surgery for this service; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 28285 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

28285 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 28285 rate is calculated

Each of 28285’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 28285

28285 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

28285 compared with similar codes

How to choose

28286Hammertoe repair

Choose 28285 for hammertoe correction. 28286 is specific to correction of a cock-up fifth toe.

28272Toe joint release

28272 describes interphalangeal joint contracture release. Use 28285 when the operation corrects the hammertoe deformity rather than reporting only a joint release.

28270Foot contracture release

28270 describes metatarsophalangeal joint contracture release. It is not the code for surgical correction of the hammertoe itself.

Codes related to 28285

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates